Associations of perceived social cohesion and mental distress in a multi-ethnic population-based sample of adults in California (analysis of 2011-2012 California Health Interview Survey)

The purpose of this study was to examine the association between perceived social cohesion assessed by neighborhood safety, neighborhood trust and community engagement and moderate and severe mental distress (MD) within a large sample of adults in California. These neighborhood characteristics along with social ties are great predictors of psychological distress, especially depression. Previous research has shown that social support resulting from social networking buffers the damaging health impact of major life events and chronic strains, however, few studies have investigated the specific features concerning mental distress and neighborhood characteristics in large-scale surveys. The California Health Interview Survey (CHIS) is the nation¡¯s largest health survey (N = 42,935, unweighted), and one of the few cross-sectional population-based surveys that includes social cohesion. This secondary analysis of CHIS data had the following hypothesis: perceived social cohesion factors such as neighborhood safety, trust and involvement are associated with moderate and severe mental distress after controlling for sociodemographic characteristics. The outcome variable MD is based on the K6 scale, with scores of 0-4 defining ¨DNo MD¡¬, 5-12 defining ¨DModerate MD¡¬ and 13-24 ¨DSevere MD¡¬. The final fitted multinomial regression model indicated that individuals who did not feel safe were more likely to report moderate and severe MD (OR=1.45, 95% CI: 1.26, 1.66; OR=1.83, 95% CI: 1.45-2.31). Those who did not trust their neighbors had greater odds of reporting moderate and severe MD after adjusting for covariates (OR=1.28, 95% CI: 1.15, 1.43; OR= 1.81, 95% CI: 1.47, 2.24). Similarly, lack of community involvement significantly increased an individual¡¯s likelihood of MD suggesting that neighborhood environment plays an important role in an individual¡¯s psychosocial state and general health. This research has important practical implications in preventing and treating MD within communities and neighborhoods. It is necessary to assess where mental health resources might be better located to design targeted interventions by identifying neighborhood characteristics of at-risk populations. Future research should include census tract geographic allocation of mental health services and resources that can be used in community redevelopments to foster supportive social networks and increase the efficacy and sustainability of communities in need.